The overall objective of this research is to evaluate the role of psychotherapy in the treatment of acute depression in outpatients. The design involves a randomized and controlled treatment trial comparing psychotherapy and a tricyclic antidepressant (amitriptyline), each alone, in combination, and in comparison with a control group which receives non-scheduled, non-drug treatment. The psychotherapy aims at facilitating the patient's interpersonal difficulties and disputes by reality-oriented "here and now" techniques. The psychotherapy is done by psychiatrists and consists of short-term (16 weeks) individual treatment. Assessments are made periodically by the patient and by clinicians who are independent of treatment, using a variety of clinical and social adjustment measures. This is a collaborative study being carried out at Boston State Hospital and the Connecticut Mental Heath Center and funded for the past two years by the N.I.M.H. Clinical Research Branch. Eighty patients have now been randomized into the study and an analysis in a partial sample has been completed. Based on these preliminary results which indicate that both treatments are efficacious and that the combination is additive, we are requesting an additional 2 years funding to include 80 new patients (thus extend the sample to 160 patients); to conduct a one-year follow-up of the total 160 patients; to conduct more extensive data analysis in the total sample including a split half replication analysis; and to complete a manual of psychotherapy procedures.